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Hand-arm bimanual intensive therapy (HABIT) enhances upper extremity (UE) function and bimanual coordination in children with unilateral cerebral palsy (UCP). Previous studies assessed immediate improvements in UE function using clinical and self-reported measures, which may not accurately reflect real-world UE performance and their long-term retention effects. Therefore, this study aims to investigate the retention of real-world bimanual performance gains over time following HABIT in children with UCP. Thirty children with UCP, age 6-16 years underwent HABIT (6 hours/day for 5 days). Bimanual performance was assessed using GT9X Link accelerometers, worn on bilateral wrists for 3 days pre-, post-, 3-, and 6-month of HABIT. Accelerometer-derived variables-use ratio (UR), magnitude ratio (MR), bilateral magnitude (BM), median acceleration (MA), and acceleration variability (AV)-quantified bimanual performance during real-world activities. UE function was measured with standardized assessments. A mixed model analysis with repeated measures and paired t-tests analyzed the differences real-world bimanual performance and UE function respectively. There was a significant main effect of time in UR (F = 2.72, p = 0.05), BM (F = 4.36, p = 0.007), and MA (F = 3.68, p = 0.016). Post-hoc analysis (mean differences, 95% confidence interval [CI]) revealed improvements immediately post- compared to pre-HABIT in BM (14.99, 4.35-25.63) and MA (7.46, 2.55-12.36). However, subsequent assessments at 3- and 6-months displayed a regression in these gains, suggesting a lack of retention. A decline was observed at 3 months) and 6 months (BM; 16.94, 6.3-27.4, MA; 6.51, 1.61-11.41) in BM and MA compared to post-HABIT. UE capacity measures also showed improvements (p < 0.05) post-HABIT. Although HABIT initially may enhance performance of real-world bimanual tasks, its benefits diminish within six months, suggesting a need for repeating HABIT every 3-6 months to retain long-term improvements., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gardas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Remote limb ischemic conditioning (RLIC) is a clinically feasible method in which brief, sub-lethal bouts of ischemia protects remote organs or tissues from subsequent ischemic injury. A single session of RLIC can improve exercise performance and increase muscle activation. The purpose of this study, therefore, was to assess the effects of a brief, two-week protocol of repeated RLIC combined with strength training on strength gain and neural adaptation in healthy young adults. Participants age 18-40 years were randomized to receive either RLIC plus strength training (n = 15) or sham conditioning plus strength training (n = 15). Participants received RLIC or sham conditioning over 8 visits using a blood pressure cuff on the dominant arm with 5 cycles of 5 minutes each alternating inflation and deflation. Visits 3-8 paired conditioning with wrist extensors strength training on the non-dominant (non-conditioned) arm using standard guidelines. Changes in one repetition maximum (1 RM) and electromyography (EMG) amplitude were compared between groups. Both groups were trained at a similar workload. While both groups gained strength over time (P = 0.001), the RLIC group had greater strength gains (9.38 ± 1.01 lbs) than the sham group (6.3 ± 1.08 lbs, P = 0.035). There was not a significant group x time interaction in EMG amplitude (P = 0.231). The RLIC group had larger percent changes in 1 RM (43.8% vs. 26.1%, P = 0.003) and EMG amplitudes (31.0% vs. 8.6%, P = 0.023) compared to sham conditioning. RLIC holds promise for enhancing muscle strength in healthy young and older adults, as well as clinical populations that could benefit from strength training., Competing Interests: The authors have declared that no competing interests exist.